Individual
SAMEEHA MENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
634 ACADEMY DR, NORTHBROOK, IL 60062-2421
(847) 637-5151
Mailing address
634 ACADEMY DR, NORTHBROOK, IL 60062-2421
(847) 637-5151
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057004574
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178802443
—
IL
Enumeration date
10/13/2016
Last updated
01/02/2019
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